Sangal Rohit B, Orloski Clinton J, Shofer Frances S, Mills Angela M
Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Emergency Medicine, Northwest Hospital, Seattle, WA, USA.
J Patient Exp. 2020 Apr;7(2):225-231. doi: 10.1177/2374373519826246. Epub 2019 Feb 22.
Patient satisfaction is emerging as a new health-care metric. We hypothesized that an emergency department (ED) informational pamphlet would significantly improve patient understanding of ED operations and ultimately improve patient satisfaction.
We performed a prospective study of patients presenting to a single tertiary care center ED from April to July 2017. All patients were given a pamphlet on alternating weeks with regular care on opposite weeks and were surveyed upon ED discharge. The primary outcome was patient satisfaction with ED care. Secondary outcomes included patient understanding of various wait times (test results, consultants), discharge process, who was on the care team and what to expect during the ED visit.
Four hundred ninety-four patients were included in this study and 266 (54%) were in the control group. Of 228 (46%) patients who were given the pamphlet, 116 (51%) were unaware they received it. Of the remaining 112 (49%) patients who remembered receiving the pamphlet, 43 (38%) stated they read it. Among those reading the pamphlet, only two statements were significant: knowing what to expect during the ED visit (88% vs 71%; = 0.012) and waiting time for test results (95% vs 75%; = 0.003) when compared to those who did not receive or read the pamphlet.
An ED informational pamphlet, when utilized by patients, does improve patient understanding of some aspects of the ED visit but does not appear to be the best tool to convey all information. Ultimately, sustained improvement in patient satisfaction is a complex and dynamic issue necessitating a multifactorial approach and other methods should be explored.
患者满意度正成为一项新的医疗保健指标。我们假设一份急诊科（ED）信息手册将显著提高患者对急诊科运作的理解，并最终提高患者满意度。
我们对2017年4月至7月到一家三级医疗中心急诊科就诊的患者进行了一项前瞻性研究。所有患者每隔一周会收到一本手册，在另外一周接受常规护理，并在急诊科出院时接受调查。主要结果是患者对急诊科护理的满意度。次要结果包括患者对各种等待时间（检查结果、会诊）、出院流程、护理团队成员以及急诊科就诊期间预期情况的理解。
本研究纳入了494名患者，其中266名（54%）在对照组。在收到手册的228名（46%）患者中，116名（51%）不知道自己收到了手册。在其余记得收到手册的112名（49%）患者中，43名（38%）表示读过。与未收到或未阅读手册的患者相比，阅读手册的患者中只有两项表述有显著差异：了解急诊科就诊期间的预期情况（88%对71%；P = 0.012）以及检查结果的等待时间（95%对75%；P = 0.003）。
当患者使用急诊科信息手册时，确实能提高患者对急诊科就诊某些方面的理解，但似乎不是传达所有信息的最佳工具。最终，持续提高患者满意度是一个复杂且动态的问题，需要采取多因素方法，应探索其他方法。
